Injury
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Observational Study
Pressure ulcers, indentation marks and pain from cervical spine immobilization with extrication collars and headblocks: An observational study.
To describe the occurrence and severity of pressure ulcers, indentation marks and pain from the extrication collar combined with headblocks. Furthermore, the influence of time, injury severity and patient characteristics on the development of pressure ulcers, indentation marks and pain was explored. ⋯ The high incidence of category 1 pressure ulcers and severe indentation marks indicate an increased risk for pressure ulcer development and may well lead to more severe PU lesions. Pain due to the application of the extrication collar and headblocks may lead to undesirable movement (in order to relieve the pressure) or to bias clinical examination of the cervical spine. It is necessary to revise the current practice of cervical spine immobilization.
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Randomized Controlled Trial
Allograft plus OP-1 enhances ossification in posterolateral lumbar fusion: A seven year follow-up.
To study the results of the combination of allograft plus BMP-7 in comparison with allograft alone in posterolateral lumbar arthrodesis. ⋯ Allograft on one side plus allograft with BMP-7 on the other achieved a fusion rate of 93 per cent. Allograft combined with BMP-7 was more effective than allograft alone.
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Motorcyclists represent an increasing proportion of road traffic casualties but, while factors associated with crashes are readily identifiable, little is known about the prevalence of those risk factors in the motorcycling population. ⋯ This study provides an account of the prevalence of key risk factors across age groups in a population of active motorcycle riders in NSW. Novice riders were represented in all age groups although most novices were under 40 years. These data can be used to guide the development of targeted countermeasures aimed at improving motorcycling safety for riders of different age groups.
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Review Case Reports
Large fracture of the anteromedial tibial plateau with isolated posterolateral knee corner injury: case series of an often missed unusual injury pattern.
Tibial plateau fractures are a heterogeneous group of lesions with multiple fracture patterns. They are often associated with soft tissue injuries, the lateral meniscus and the anterior cruciate ligament (ACL) being the most common structures affected. ⋯ The importance of a high index of suspicion and a proper early diagnosis with an MRI is of paramount importance. We also describe the current surgical management used by the authors and review of the current literature.
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Alcohol, a common risk factor for injury, has direct toxic effects on the liver. The use of lactate clearance has been well described as an indicator of the adequacy of resuscitation in injured patients. We investigated whether acutely injured patients with positive blood alcohol content (+BAC) had less lactate clearance than sober patients. ⋯ In a large group of acutely injured patients, a dose-dependent decrease in lactate clearance was seen in those with elevated BAC. This relationship will cause a falsely elevated lactate reading or prolong lactate clearance and should be taken into account when evaluating patients with +BAC.